Aim Stomach inflation during mask ventilation is frequent, but the effects on haemodynamic and pulmonary function are unclear. We evaluated the effects of stomach inflation on haemodynamic and pulmonary function during spontaneous circulation in a porcine model. Methods Randomised prospective animal study. After randomisation, in 23 domestic pigs the stomach was inflated every 90 s with 0 L (control; n = 8), 0.5 L ( n = 7) or 1 L ( n = 8) ambient air. Results After 22.5 min, i.e. 8.5 L in the 0.5 L and 17 L in the 1 L stomach inflation group, stomach inflation increased central venous pressure (median) (control: 10 mmHg vs. 1 L: 23 mmHg, P < 0.05) and mean pulmonary artery pressure (control: 24 mmHg vs. 1 L: 45 mmHg, P < 0.05). As a result stroke volume index decreased (control: 135 mL/kg vs. 0.5 L: 90 mL/kg, P < 0.05; vs. 1 L: 72 mL/kg, P < 0.05). Stomach inflation also decreased static pulmonary compliance (control: 24 mL/cmH 2O vs. 0.5 L: 8 mL/cmH 2O, P < 0.05; vs. 1 L: 3 mL/cmH 2O, P < 0.05), which increased peak airway pressure (control: 28 cmH 2O vs. 0.5 L: 69 cmH 2O, P < 0.05; vs. 1 L: 73 cmH 2O, P < 0.05). Additionally, arterial oxygen partial pressure (control: 305 mmHg vs. 0.5 L: 140 mmHg, P < 0.05; vs. 1 L: 21 mmHg, P < 0.05) and systemic oxygen delivery (control: 53 mL O 2/min vs. 1 L: 19 mL O 2/min, P < 0.05) decreased. Stomach inflation increased mortality (control: 0/8 vs. 1 L: 5/8, P < 0.05). Conclusions Stomach inflation with 1 L when compared to 0.5 L increments resulted in faster haemodynamic and pulmonary failure and increased mortality. Stomach inflation may cause a hyper-acute abdominal compartment syndrome.
Read full abstract